Surgical Gynecology

Depression And Back Pain Problems

Back pain includes depression, which emerges from fractures. Fractures include pathologic, complete/incomplete, avulsion, comminuted, depressed, compression, and oblique, greenstick, simple, compound, spiral, and transverse. The conditions noted in hip fractures include intracapsular, Intertrochanteric, and extracapsular.

Each problem rests within the blood vessels, yet it starts with fractures. Blood vessels make up the arteries, capillary, and veins. As you can see chest pain can lead to back pain, since the blood vessels travel. Overexerting the bones can cause fractures, which lead to depression and related symptoms.

In fact, damage here may derive from osteomyelitis, Cushing’s syndrome, bone tumors, aging, malnutrition, immobility, multiple myeloma, osteoporosis, trauma impacts, and so on. Fractures can lead to serious back pain. When fractures break the bones, it affects the bone covering known as penosteum. The covering is transparent and has a rich outlay of neurons. Fractures often are caused by trauma impacts, such as car accidents, falls from horses, etc.

The signs:

If neurological conditions are, involved the patient will feel toe numbness. The legs and feet may feel weak. Abolish reflexes are reduced if the fracture is at the lower region of the back. Muscle spasms and muscle reflexes often occur at the higher area of the back. If you have such fracture, bed rest is recommended to reduce the pain. If acute back conditions exist, experts will need to assess the problem. Broken back is an acute condition, which you should avoid rolling, or logrolling.

Fractures include the stable and unstable breaks. If the fracture is unstable, it can severely damage the spine. In such case, the doctor will surgically correct the problem or recommend that the patient wear a cast. The damage can tear the nerves. If you feel you have broken your back, you are wise to avoid atypical movement, since it will progress the problem when pressure is applied to the area.

If the fracture is spontaneous, the doctor can help minimize the pain by prescribing a brace. You will need to avoid applying weight to the area where the fracture rests. Bad falls can break the coccyx, which can sit in coccygodynia. Below the triangular bones at the lower back and near the baseline of the spinal column, the hips are joined with bones that set on either side and form parts that connect to the pelvis. (Sacrum) This area joins with five merging bones, which are fused with the sacrum and is commonly known as the coccyx.

Fractures emerging from the coccyx may include bruising of the periosteum, which is treated by steroid injections. Periosteum is a membrane, which the connective’ tissues meticulously empower each bone within the skeletal structure, excluding the articular exteriors.

Fractures can also invent bursitis. When one of the bursa is disrupted it will inflame, swell, and cause pain. The problem emerges from friction. Friction is often increased when bursitis starts, since instead of separating particular tissues, the fluids emerging from bursa stand in the way. Bursitis includes obturator internis, trochanteric, and ischial. Bursa conditions such as the named rest near the buttocks, lower back, and hip.

To avoid bursitis you may want to avoid sitting, standing, or lying in one position at all times. Instead, shift your resting states. Doctors will often inject a mixture of anesthetic lidocaine and steroids to correct bursitis.

In addition to fractures and bursitis, back pain can start from gynecological conditions. The condition is related to reproductive organs and disease. Females are the prime targets who experience pain from this condition. The condition causes pain, swelling, and inflammation. The condition will affect the spinal cord.

The Ovarian Cysts Types, Symptoms and Diagnosis

The fluid-filled sac, which usually develops on the surface of an ovary, is a problem that affects many women. This is also called the ovarian cyst, and there are known a lot of different types, depending on the cause that provoked them. These ovarian cysts can show no symptoms at all, or they can cause serious health problems.

Situated on either side of the uterus, the ovaries have a walnut-size, and are nestled under the fringed ends of the fallopian or uterine tubes. During the menstrual cycle, an egg will be developed and matured by an ovary, and when the ovulation takes place, the egg is released and it travels through the uterine tubes to reach the center of the uterus.

Most of the ovarian cysts aren’t dangerous, they are the so called functional cysts. Studies revealed that between 4% and 10% of the childbearing age women develop polycystic ovarian syndrome. The effects of that syndrome are infertility, increased risk of diabetes, uterine or breast cancer, excessive body hair, persistent acne, and other.

Ovarian cysts may cause pelvic pain, they may burst, bleed, or twist the ovary. Especially if the pain is associated with fever and vomiting, visiting the doctor is a necessary fact.

There are some ovarian cysts that can become cancerous. They appear especially at women who are in their fifth decade of life. It is known that cancerous cysts are not painful unless they are very big in size. It is recommended that women take annual pelvic exams, so they can detect cancer in early stages.

It is quite difficult to know if you have cysts or not, because many cysts don’t have symptoms, and very often, vague abdominal symptoms may suggest other problems. For example, intestinal inflammation or obstruction, kidney stone, gall bladder disease or appendicitis develop similar symptoms to painful ovarian cysts. There are some gynecologic problems with those symptoms too: endometriosis, ectopic or tubal pregnancy, pelvic inflammatory disease, and also mittleschmirtz.

Generally, a few symptoms that can be associated to the ovarian cysts are: pelvic pain during intercourse, feeling of pressure on your bladder or rectum, menstrual irregularities, breast tenderness, nausea, pelvic pain just before your period begins or just after it ends, continuous, creamy or clear-like-eggwhite vaginal discharge that persists unchanged for a month or more. If you have any of these symptoms, especially associated with fever, signs of shock, or vomiting, medical assistance is needed.

Functional cysts compile the more usual category of cysts, they are non-pathogenic, and usually they disappear after ovulation. Sometimes, there is a blemish and the cyst may stay a little longer.

There are two types of functional cysts: follicular, and corpus luteum cyst.

Usually, when the egg is matured, it is released from the follicle, and is traveling through the fallopian tube, where a sperm cell might fertilize it .If the follicle doesn’t rupture, it will grow, becoming a cyst. These cysts usually do not cause pain, and disappear in two or three menstrual cycles.

When the pituitary gland is increasing the luteinizing hormone, and the egg is released, the follicle becomes a temporary secretory gland called the corpus luteum. It might happen the corpus luteum to enlarge as a cause of certain accumulations, and become a cyst, but it will disappear after a few weeks. In very rare situations, a corpus luteum cyst can reach the size of three or four inches in diameter and twist your ovary or bleed into itself, causing abdominal pain.

Dermoid cysts are small, and they usually do not cause symptoms. They can contain different tissues, but mostly are fat .Becoming large, causing rupture and pain is a rare thing at these cysts.

Endometrioma appears when the ovary is invaded by the endometrial tissue. This cyst fills with blood, and has a dark, reddish-brown color. It is also called chocolate cyst. It doesn’t show any symptoms usually, but it can be sometimes painful, especially during intercourse, or during your period.

The cysts that form from cells on the surface of the ovary are called cystadenomas and are usual benign. Sometimes they can become large, and cause pain.

The polycystic ovary is particular to women who don’t ovulate on a regular basis. The ovaries contain many small cysts, and are enlarged. There are known many causes that can cause a woman not to ovulate and develop polycystic ovaries.

Ovarian cysts can be discovered by taking some medical examinations. A pelvic exam supposes the doctor palpating your ovaries, and if there exists the suspicion of a cyst, you will have next a pelvic ultrasound exam. During that exam, sound waves are transmitted to your pelvic area, and on a video screen appears the image of your ovaries. The doctor is analyzing that imagine, trying to determine the nature of the cyst.

The doctor can also perform laparoscopy, which is a surgical procedure consisting in a small cut, through which is inserted a thin, lighted telescope into your abdomen. This method can be used for diagnosis and for treatment also.

For more info about ovarian cyst surgery or even about ovarian cysts/ please review this page http://www.ovarian-cysts-center.com/

Frequently Asked Questions About Infertility

It is an accepted fact that all living beings on the earth are able to reproduce. In fact the urge and desire to reproduce and keep the line going is central to all beings. Infertility not only disturbs the lives of the couple, but also affects their near and dear ones, who love them and want to see them happy. Here we are going to discuss a few questions, frequently asked by people.

What is Infertility?

Due to certain disease or inadequacies, natural conception does not take place, it is called infertility. This infertility could be in the male, or in female, or in rare cases in both. Infertility is established only when pregnancy does not take place despite repeated efforts over a period of time, perhaps a year or so. Also, in cases of those women who end up having miscarriages are also termed infertile.

Frequency of infertility in the USA

Nearly 1 in 10 couples in the US are unable to reproduce. Infertility is due to the male in 33% of the cases and the same percentage is due to the female. Nearly 15% are caused by problems with both, the male and the female, and the remaining balance percentage is made of various other causes.

How to check infertility in men?

The physical and mental state of the patient is checked, a record of past diseases and accidents and other significant occurrences is noted. This is followed by pathological tests of blood and so on to trace any past or existing disease, and hormone imbalance. If nothing abnormal is discovered, semen samples are then taken for tests. The quantity of semen, the sperm count, and its mobility are checked. A physical check up of the genitals is done to ensure that there is no tenderness, or cyst in and around the testis.

How to check infertility in women?

In the case of women, again past medical record and complete physical health check up is done. This is followed by a more detailed examinations and tests. Tests are done to find hormonal imbalance, the state of the lining of the uterus, and the functioning of the thyroid. A laparoscopic examination of the organs is done and a detailed check carried out of progesterone is made to establish that there is proper ovulation, which will lead to pregnancy, is taking place or not.

What causes male infertility the most?

Male infertility may occur due to two main reasons; (i) when zero sperm cells are produced, which is also known as Azoospermia, and (ii) when only a minimum number of sperm cells are produced, which is known as Oligospermia. Other than the above discussed two problems, sometimes its due to improper production of sperm cells, they die even before fertilization. In rare cases, there are some genetic concerns like, cystic fibrosis or some abnormality in chromosomes may lead to the problem.

What are the most common causes for female infertility?

There may be various causes for female infertility. The female reproduction system is complicated, even a small imbalance can affect the normal reproduction process. Generally, blocked fallopian tubes or improper ovulation are the reasons for the concern. Frequent miscarriages also may lead to the problem. Apart from these, age is also an important factor. A woman’s ability to conceive is affected after the age of 35, due to less production of eggs after that age.

What is ART?

ART (assisted reproductive technologies) is a term given to explain the various methods which may help infertile couples to have a child. The process of ART is not a simple one. It includes surgically taking out of eggs from a female’s ovaries, fertilize them with sperm in a laboratory, and once this step is done, implanting the fertilized egg back into the female’s uterus.

When can in vitro fertilization be taken?

IVF (in vitro fertilization) can be undertaken, when the fallopian tubes of a woman are blocked or one of them is missing. This method can also be tried out in case of low sperm count in a male. IVF method has been proved to be very effective and has given positive results to millions of couples. In this method, a woman’s egg is taken out and fertilized with sperm in a laboratory. Then it is put back into her uterus again.

Are there some medicines to treat infertility in females?

There are a few medicines like, follicle stimulating hormone (FSH), metformin and bromocriptin, clomiphen citrate, etc., prescribed to cure infertility in females.

Where can we find information about infertility?

Following are where more information regarding infertility problems can be obtained;

National Women’s Health Information Center (NWHIC)

The American College of Obstetrician and Gynecology (ACOG) Resource Center

The Food and Drug Administration (FDA)

The National Infertility Association

The International Council on Infertility Information Dissemination, Inc.

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Sudden Hair Loss

Female pattern baldness is a major cause of hair loss among women. Apart from that, women also experience sudden hair loss or localized hair loss. It is the most common among all female hair loss problems.

In sudden hair loss, a woman suffers from generalized thinning affecting all parts of her scalp. However, the problem causes only thinning of hair and not any hair fall. A woman suffering from this problem is not a good candidate for hair transplantation surgery.

Factors causing sudden hair loss

Hereditary balding is not the usual cause of sudden hair loss. The cause might be nutritional deficiency.

Telogen Effluvium (TE) is a condition which causes the hair to be shifted into a resting, non-growth stage on the scalp, and shed after several months. This condition is sometimes confused with female pattern baldness. However, they are different. TE is trigged by the intake of a large number of drugs. The hair fall in this condition can be reversed by stopping the medication.

How is TE caused? It happens when the number of hairs in the growth phase drops and the Telogen stage of hair follicles increases. There is no certain pattern except general thinning of the hair. It is mainly the telogen hair which suffer the fall. The Telogen phase production causes gradual thinning of hair. Why? Because it does not give the time for the anagen phase to begin.

Trichorrhexis nodosa (TN) is another condition causing temporary female hair fall. The reason behind this condition is the absence of cuticle at some places, resulting in swelling at those places. Its usual cause is excessive hair manipulation. Overuse of hot combs and waves in hair styles are the causal factors.

Traction alopecia (TA) and trichotillomania are two conditions causing female hair loss. The main cause of TA is hair styles that include pulling at the hair roots like tight pony tails and cornrow hair style. The pulling at the hair roots sometimes causes serious damage to the hair follicle, which may ultimately result in permanent hair loss in women.

How can one develop Trichotillomania? It happens when a woman obsessively keeps pulling out her own hair, may be unconsciously.

Some other reasons for sudden hair loss

There are certain other reasons for sudden hair loss. They have no link with heredity and are mostly health related. These causes include anemia, thyroid dysfunction, endocrine problems, gynecological conditions like ovarian tumors, connective tissue disease, surgical procedures, crash diets and emotional stress.

Medications those are responsible for sudden hair loss

Sudden hair loss in women can also be caused by certain medications. These medications include oral contraceptives, thyroid medication, blood pressure medication, mood enhancing medicines and anti-depressants, cholesterol lowering medications and drugs such as cocaine or LSD.

The solutions

The problem can be solved by removing the causes of hair fall. That ultimately results into hair re-growth. In case the hair fall is caused by the use of some medication, then the problem can be solved by avoiding its use.

You better avoid the use of brushes on hair and hair styling involving chemicals. Using mild shampoo will be god choice.

Cholelithiasis – Definition, Causes, Symptoms and Treatment

Cholelithiasis also known is Gallbladder. Gallstones are concretions that form in the biliary tract, usually in the gallbladder. Gallstones are formed within the gallbladder, an organ that stores bile excreted from the liver. Further complications of gallbladder disease include gallstone pancreatitis, gallstone ileus, biliary cirrhosis, and gallbladder cancer. Gallstones may be as small as a grain of sand, or they may become as large as an inch in diameter, depending on how long they have been forming. A stone blocking the opening from the gallbladder or cystic duct usually produces symptoms of biliary colic, which is right upper abdominal pain that feels like cramping. If the stone does not pass into the duodenum, but continues to block the cystic duct, acute cholecystitis results. Gallbladder calculi are relatively uncommon in children. However, the incidence of cholelithiasis has been increasing recently. Children may harbor cholesterol gallstones, black- or brown-pigmented stones, or mixed-type gallstones. Complications that occur in adults with this condition may also occur in children. Gallstones may cause irritation and inflammation of the gallbladder mucosa, resulting in chronic calculous cholecystitis and symptoms of biliary colic. Chronic gallstone disease may lead to fibrosis and loss of function of the gallbladder and predisposes to gallbladder cancer. Excision of the gallbladder (cholecystectomy) to cure gallstone disease is among the most frequently performed abdominal surgical procedures.

Gallstones are a common health problem worldwide. Gallstones can occur anywhere within the biliary tree, including the gallbladder and the common bile duct. Obstruction of the common bile duct is choledocholithiasis; obstruction of the biliary tree can cause jaundice; obstruction of the outlet of the pancreatic exocrine system can cause pancreatitis. Gallstones are rocklike collections of material that form inside the gallbladder. Different types exist, and they are categorized by their primary composition; cholesterol stones are most common (75-80% in the United States) followed by pigment, then mixed stones. The stones form when there is an imbalance or change in the composition of bile. The first is how often and how well the gallbladder contracts; incomplete and infrequent emptying of the gallbladder may cause the bile to become overconcentrated and contribute to gallstone formation. The second factor is the presence of proteins in the liver and bile that either promote or inhibit cholesterol crystallization into gallstones. Increased levels of the hormone estrogen as a result of pregnancy, hormone therapy, or the use of birth control pills, may increase cholesterol levels in bile and also decrease gallbladder movement, resulting in gallstone formation. The pain of biliary colic is not characteristically positional, pleuritic, or relieved by bowel movement or flatus.Other symptoms, often associated with cholelithiasis, include indigestion, dyspepsia, belching, bloating, and fat intolerance. However, these are very nonspecific and occur in similar frequencies in individuals with and without gallstones; cholecystectomy has not been shown to improve these symptoms.

Gallbladder sludge is crystallization within bile without stone formation. Cholesterol gallstones may become colonized with bacteria and can elicit gallbladder mucosal inflammation. Lytic enzymes from bacteria and leukocytes hydrolyze bilirubin conjugates and fatty acids. Gallstones are present in about 80% of people with gallbladder cancer. Symptoms of gallbladder cancer are usually not present until the disease has reached an advanced stage and may include weight loss, anemia, recurrent vomiting, and a lump in the abdomen. When the cancer is caught at an early stage and has not spread deeper than the mucosa (the inner lining), removal of the gallbladder results in five-year survival rates of 68%. If cancer has spread to deeper layers, more extensive surgery or other treatments may be required. Sickle cell disease has been identified as an independent risk factor associated with an increase in the frequency of cholelithiasis. Cholesterol gallstones develop when bile contains too much cholesterol and not enough bile salts. Besides a high concentration of cholesterol, two other factors seem to be important in causing gallstones. Acute gallstone pancreatitis is often characterized by epigastric tenderness. In severe cases, retroperitoneal hemorrhage may produce ecchymoses of the flanks and periumbilical ecchymoses.

There are several available treatments for Cholelithiasis. Electrohydraulic shock wave lithotripsy (ESWL) has also been employed to treat cholelithiasis. Urodeoxycholic acid (UDCA, ursodiol), a more contemporary medical therapy, is successful in only 40% of cases. Both CDCA and UDCA therapies are useful only for gallstones formed from cholesterol. Surgery-Removal of the gallbladder, or cholecystectomy , is usually needed to treat symptoms associated with gallstones. It is a relatively safe procedure that does not cause any nutritional problems. Oral Bile Salts-If surgery is not desirable, bile salts to dissolve gallstones can be taken by mouth. However, it may take a long time to dissolve the gallstones, and because the gallbladder is still present, gallstones may recur. Laparoscopic techniques, which have been used for years in the field of gynecology, have recently been adapted to cholecystectomy, in an effort to decrease complications, recovery time and cost. Laparoscopic cholecystectomy is associated with a lower incidence of intra-abdominal adhesions, wound site hernia and scar formation. Postoperative pain is also reduced, and recovery time is shorter. Lithotripsy has been investigated as adjunctive therapy for failed endoscopic stone retrieval and for retained ductal stones after laparoscopic cholecystectomy.

Back Pain Symptoms & Treatment

Here’s one problem you can’t turn your back on! But you can get some relief from knowing that very few people turn out to have a major problem or a dangerous medical condition involving the bones or joints of the back. In fact, often the exact cause of a person’s back pain can’t be pinpointed exactly. Many causes result from everyday activities and clear up by themselves within a relatively short time period. Whether your back pain requires a doctor’s care or not, chances are you’ll be “back” to normal in no time.

Back pain may be blamed on poor muscles tone in the back, muscle tension or spasm, back strains, ligament or muscle tears, bone weakness and/or joint problems. If you have a so called “slipped disc” in your spinal column, you may suffer buttock of leg pain, numbness, tingling of weakness in the bones of legs due to irritation of nerves from the spinal cord. Emotional stress of long periods of inactivity may worsen back pain.

People in poor physical condition (including obesity) or those who do work that includes heavy labor or long periods of sitting or standing have a higher risk of developing low back problems; they also get better more slowly.

Occasionally back pain can be due to other conditions. These include arthritis, ulcers or other intestinal problems, kidney disease, pregnancy or other gynecological conditions, heart diseases, bone injuries and cancer. If back pain seems unrelated to an injury or activity, or is in any other way unusual, a visit to the doctor is recommended.

Symptoms

Back pain is usually confined to the lower back, but it may extend to other areas, particularly the legs. Affected parts of the back may feel tender or sore to the touch and the pain may increase with movement. Pain can be felt as sharp of knife-like, a burning sensation or as a dull muscular ache. Symptoms can range from mildly uncomfortable to completely disabling.

Treatment

Most episodes of mild back pain will improve without any medical intervention. Over the counter medications such as acetaminophen and ibuprofen can provide temporary relief. It’s a good idea to avoid overly strenuous or repetitive activity, but bed rest should generally be avoided. In fact, numerous clinical trials have confirmed that continued activity and prescribed exercises reduce back discomfort and result in more rapid recovery. Exercise and healthy diet can be followed to make bones healthy. In addition, a good exercise program may help prevent recurrence-common with back pain. Check with your doctor if your symptoms worsen or don’t improve rapidly.

Other helpful back pain treatments include physical therapy, massage and spinal manipulation. In addition, a panel from the National Institutes of Health has concluded that acupuncture may be useful as one form of treatment in a comprehensive management program for back pain. Surgical treatment of back pain is dictated but by the type of structural problem that is causing the pain. In some cases, surgery can be a highly effective option.

An Enlightened Approach to Kegel Exercises

We’ve all heard that a definition of insanity is doing the same thing over and over again, but expecting a different result.

Isn’t that what we’ve done for years with Kegel exercises? Countless hours of practising while wondering if we’d got the right muscle, or if there was any point in doing the exercises anyway as we weren’t really feeling that our effort was making any difference.

A little known fact about Kegel exercises which often surprises people when they first hear it is that they were never meant to be performed the way in which they are today. Indeed, they were never meant to be performed the way they have been for decades!

Dr Kegel was an American surgeon, Associate Professor of Gynaecology at the University of Southern California and Health Commissioner of Chicago, who spent more than thirty-two years in the study of the female pelvis and the muscles therein.

His studies document his results with thousands of women that show the incredible benefits to be gained from Kegel exercises when performed correctly. In 1950 Dr Kegel had achieved complete relief of urinary stress incontinence in 93% of a group of 300 women in this way.

“On the strength of these favorable results urinary stress incontinence in women is no longer routinely treated by surgical intervention at…LA County General Hospital.” Dr Kegel. (A progress in Gynecology, 1950 p.786)

Isn’t it amazing to think that the results he was getting in the last century are even better than the generally accepted success rates for incontinence surgery carried out today? How were these results achieved? By ensuring that the exercise protocol that his patients followed consisted of two essential elements:

1) Isolating the pelvic floor muscle (using no abdominal, buttock or thigh muscles) 2) Working the pelvic floor muscle against resistance

What is commonly known as a Kegel exercise today bears little relation to authentic Kegel exercises. Dr Kegel knew that the exercises were pretty useless without either of these components. If you’ve been struggling to get results with Kegel exercises, maybe for years, now you know why they seem to be exercises in futility.

Think about it like this – Squeezing against nothing is about as effective as trying to rehabilitate or build muscle in your arm simply by flexing it up and down, you could do that forever and see little improvement. However, put a small weight in your hand and exercise against the resistance of that, adding slightly heavier weights as the arm gets stronger and improvement in strength and tone is inevitable.

Imagine going to the gym and finding all the equipment has been taken out and you’re told you can go through the motions of doing the exercise and achieve the same result! This is what women have been told about pelvic floor exercise over the last half century, and still are. By merely going through the motions of doing the exercise you cannot come close to achieving the results that come from actually doing the proper exercise.

Dr Kegel was quoted in TIME magazine, Dec 3rd, 1956 as saying, “There is a better way than surgery to correct most cases of pubococcygeal weakness”